Utility of Detecting sof Gene as Evidence of Streptococcus pyogenes Infection in Acute Rheumatic Fever

Objectives: To determine the diagnostic accuracy of polymerase chain reaction-baseddetection of sof gene compared to throat swab culture for S. pyogenes infection in patientswith acute rheumatic fever and those with recurrence of rheumatic activity. Methods: 40patients between 3 to 18 years of age, with clinical diagnosis of acute rheumatic fever or newactivity in established rheumatic heart disease were included. The amplicon of 228bp of sofgene was detected using a polymerase chain reaction-based technique and the results werecompared with throat swab culture for Streptococcus pyogenes. Results: 10 patients hada positive throat swab culture and 11 had sof gene detected. The sensitivity and specificityof the test was 100% and 96.7%, respectively compared to throat swab culture (P=0.001).The positive predictive value and the negative predictive value was 90.9% and 100%respectively. Conclusions: Polymerase chain reaction-based detection of sof geneprovides an alternative to throat swab culture in diagnosing activity in Acute RheumaticFever or established Rheumatic heart disease.

Clinicopathological study of salivary gland tumors: An observation in tertiary hospital of central India.

Background: The salivary glands are one of the few tissues in the body that are subjected to diverse and heterogeneous range of tumors and tumor like conditions. The relative infrequency of these tumors makes their diagnosis and management quite complicated. Fine needle aspiration cytology (FNAC) is a useful diagnostic procedure which has a recognized role in the evaluation of salivary gland lesions. A pre-operative diagnosis about nature of lesion, whether benign or malignant, will help in making decision about proper management of patient. Objective: Aim of this study was to know the epidemiology of salivary gland tumors in our region and to evaluate sensitivity, specificity and diagnostic accuracy of fine needle aspiration cytology taking histopathology as the gold standard. Method: It was prospective observational study conducted in department of pathology in our institute. Total 100 cases were studied with particular reference to age, sex, site, cytologic details & histological types as per WHO classification. FNAC & histopathological examination was done in all cases. Correlation between cytological & histopathological diagnoses was assessed. Diagnostic accuracy of FNAC was evaluated by comparing cytological & histopathological diagnoses. Results: Parotid gland was the most common site of involvement (70% cases). Maximum number of patients was in age range of 41-50 years & male to female ratio was 0.8:1. Most common benign & malignant tumors were pleomorphic adenoma (69.89% cases) & mucoepidermoid carcinoma (8.60% cases) respectively. On cytology, 93 cases while on histopathology 96 cases were diagnosed as neoplastic. Cytological diagnoses correlated with histopathological diagnoses in 94% cases. Sensitivity, specificity & diagnostic accuracy of FNAC were found to be 96.87%, 100% & 96% respectively. Conclusion: FNAC in salivary gland masses is fairly reliable for correct preoperative diagnosis. Multiple sampling and special attention to cytologic features should help to minimize errors.

Analgesic and anti-infl ammatory properties of the aqueous extract leaves of Murraya koenigii linn in small animal models.

Background: The present study was carried out to evaluate the analgesic activity of aqueous extract leaves of Murraya koenigii linn in Albino rats using tail fl ick method, Eddy’s hot plate methods and anti-infl ammatory activity in Carrageenan induced paw edema in rats. Methods: The analgesic activity was evaluated using Eddy’s hot plate induced hyperalgesia and tail fl ick method, which served as thermal induced pain, where the animal were placed on the hot plate and the reaction time to (lick the paw/ jump out) from the hot plate was observed, 0, 30, 60, 90 mins. Murraya 300 mg, 600 mg/kg/body weight (BW) and ibuprofen (5 mg/kg BW) was administered per oral. The anti-infl ammatory activity was measured by Carrageenan induced paw edema volumes at 0, 1, 2, 3 and 4 hrs using mercury plethysmometer, which served as chemical induced pain models. Results: The mean reaction time in Murraya at a dose of 600 mg/kg at 0 min 5.45±0.72, at 30 mins 6.52±1.03, at 60 mins 7.6±0.81, at 90 mins 8.8±0.63 respectively. The mean reaction time increased signifi cantly with Murraya at dose of 600 mg/kg when compared with control. In the ibuprofen group, the mean reaction time at 0 hr was 0.28±0.04, at 1 hr 0.34±0.05, at 2 hrs 0.46±0.03, at 3 hrs 0.61±0.05, at 4 hrs 0.76±0.05. The mean reaction time Murraya in group 600 mg/kg at 0 hr 0.27±0.04, at 1 hrs 0.39±0.03, at 2 hrs 0.48±0.06, at 3 hrs 0.68±0.05, at 6 hrs 0.80±0.03, respectively. Conclusions: The results indicate that the aqueous extract of Murraya (leaf) extract revealed signifi cant analgesic and anti-infl ammatory in thermal and chemical induced pain models.

Molecular diagnostics in genodermatoses - simplified.

The field of genetics in dermatology has progressed at an astonishing rate. Most of the known single gene disorders have at least been mapped to a particular chromosomal region and the causative genes have been identified and studied in many of them. However, most research work in genetics relating to genodermatoses has been confined to the western population. Very few reports, if any, have been published from Indian studies. A first step may be to develop a registry to link most of these cases providing a full description of the clinical phenotype. We would next need to attempt genetic analysis of these conditions thereby detecting any novel mutations in known and unknown genes different from the western population. This would help in designing indigenous assays appropriate to the Indian population. The review describes various techniques used in a molecular biology/ genetics laboratory with special focus on polymerase chain reaction (PCR), gene sequencing, genotyping and DNA micro arrays. Gene identification strategies have also been described with appropriate examples in dermatology.

Fulminant hepatic failure complicating visceral leishmaniasis in an apparently immunocompetent child.

Fulminant hepatic failure (FHF) is an unusual complication of visceralleishmaniasis (VL). Here, we present a 1.5-yr-old girl with VL developing rapidly progressive fatal FHF. In absence of established guidelines, additional use of immunomodulatory therapies has been discussed in reference to available information.

Sodium stibogluconate and polymorphic ventricular tachycardia.

Numerous antimicrobials including pentavalent antimonials are implicated in causing prolong QT-interval and ventricular tachycardia. Torsades de pointes is rarely documented with use of sodium stibogluconate. Here is described a 12-yr-old girl with visceral leishmaniasis, who developed syncopal attacks, prolong QT-interval, polymorphic ventricular tachycardia and torsades de pointes after completing a course of Stibogluconate (20 mg/kg/day for 30 days). Prolong lidocaine infusion and cardioversion were life saving.